“There’s not one definition of a specialty drug…specialty drugs have a vague group of criteria that many times isn’t clear. You have to find out how your plan defines specialty drugs. If you find generic drugs on a specialty list, you need the right people by your side to fix that.” — Vinay Patel, founder of Mako-Rx
Read MoreA simple cup of hot tea. What can it do for you? It could compete with a soon to be trillion-dollar industry. GLP-1s or “semaglutide” as some call it, has taken the US by storm and will make its way across first-world countries soon enough. Its makers are already making billions per year in the US. It won’t be long before billions become trillions. Read on for more.
Read MorePatients who receive medical balance bills are ill-prepared to decipher what they’re being billed for and why. If there’s any chronic disease more prevalent than healthcare “pricing toxicity”, we don’t know what that might be. Plenty of us calling for transparency in healthcare throw the term “payment integrity” on the table as often as possible. If we stop talking about it, then the predatory billers win…and we just can’t have that.
Read MoreSpoiler alert. Intermittent fasting and consistent exercise will give you the same results but with better health as an ultimate outcome...not worse health because of a drug your body didn't really need. This week’s article in BenefitsPro about the 10K patients who are suing the makers of the GLP-1s like Ozempic and Wegovy was inevitable.
Read MoreWhen BCBSNC tells us they prefer brand name drugs to low-cost generics, we did some fact checking.
Read MorePhysicians who want their autonomy back and the other stakeholders who also see the value there can all come together on January 20th, 2024 in Columbia, SC at the Riverbanks Zoo for a networking event. Don’t wait to get registered at www.indedocs.com. We’ll hear from doctors, health plans, legislators and employers who have a role to play in solving tough problems in our healthcare system. While others may be convinced that bigger is better in healthcare; there are still those of us who believe that local communities have a better handle on how to fix the problems that affect them most.
Read MoreWhen it comes to health plan compliance the Consolidated Appropriations Act of 2021 is the most recent law we have to spend time learning about. In this podcast, Tony Sorrentino, President of Health Plan Fiduciary Guides (HPfid), gives us some compelling food for thought and action items.
Read MoreI’m not a huge fan of SciFi as a genre. Mainly because I don’t identify with the future state that’s controlled by robots and I don’t want to admit that our futures are a grim reality of the outcomes of our current day choices. When I read, “2060” by Dr. Richard Young, it made me realize that I need to grow up, grow a spine, grow a pair…whatever your cliche for “pull up your big girl pants and fix this thing” is. Our healthcare system is going to eat up every possible dollar there is to spend on infrastructure, education, quality of life and more if we don’t do something. Listen to Cristy Gupton and Dr. Young talk about his latest book and pick up a copy right away. You won’t regret this eye-opening glimpse into our futures if we stay still.
Read MoreHospitals in America have become major corporate entities with the power to bankrupt you and your employees. But yet, they claim to be “not-for-profit”. What gives? Well, the devil is in the details and many hospitals have become masters at hiding the details. There’s an ace in your hand though. It’s section 501R of the Internal Revenue Code. Never heard of that? Well, you’re in luck if you’re a subscriber to Healthcare Solutions Podcast. Listen here and learn.
Read MoreHealthcare is consistently the #2 or #3 highest expense on an employer’s balance sheet. There’s no denying that you’re in the healthcare business even if you don’t think you are. That’s why it’s important to view your organization’s healthcare spend as every other high-cost expenditure you have and manage it accordingly. After all, the Employee Retirement Income Security Act (ERISA) and the Consolidated Appropriations Act of 2021 (CAA) require you to pay close attention to it. Step one? Listen to this podcast with Cristy Gupton and Kari Niblack as they give you food for thought regarding your employee health plan.
Read MoreMoose Pharmacy, a local, independent, community pharmacy in the suburbs of Charlotte, NC recently won a national award for having one of the 50 best health plans in America. After a competitive vetting process, the pharmacy’s employee health plan stood tall up against employers who were hundreds of times larger than them. Moose Pharmacy and Cristy Gupton of Custom Benefits Solutions started working together 3 years ago to improve healthcare and lower costs for employees and their families.
Read MoreRecently, the NC General Assembly voted to approve a bill that would allow the state’s largest healthcare services organization (notice I didn’t say “health insurance company”) to continue its vertical integration scheme while using policyholder contributions and taxpayer dollars to fund their expansion. What employers should be upset about with that is the favoritism those lawmakers are showing to BCBSNC. Did those same legislators pass a bill in your favor that would help your company grow? Nope. The message here is that there’s more than one health insurance option in this country and it doesn’t have to bear the logos of Blue Cross, UnitedHealthcare, Cigna or Aetna. Give another option a close look. You’ll probably find a partner more aligned with your interests than you realize.
Read MoreMoose Pharmacy is offering its employees mobile urgent care. Click here to watch the video
Read MoreCristy Gupton and Doug Aldeen continue discussions on the role of a fiduciary and how the new transparency law is going to make it easier for those charged with that task to honor their duty.
Read MoreCristy Gupton and Doug Aldeen have a great discussion about fiduciary duty and how the new transparency law is going to make it easier for those charged with that task to honor their duty.
Read MoreTune in for the continuation of my conversation with Dr. Keith Smith, medical director of Surgery Center of Oklahoma and co-founder of the Free Market Medical Association.
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